Šín Robin, Štruncová Denisa
Department of Infectious Diseases and Travel Medicine, Faculty of Medicine in Pilsen, Charles University, University Hospital Pilsen, Pilsen 30599, Czech Republic.
Department of Anaesthesiology and Intensive Care Medicine, University Hospital Pilsen, Pilsen 30460, Czech Republic.
World J Clin Cases. 2021 Aug 26;9(24):7218-7223. doi: 10.12998/wjcc.v9.i24.7218.
We present a rare case of status epilepticus in a 56-year-old man which arose as a complication after vaccination with the coronavirus disease 2019 (COVID-19) mRNA-1273 vaccine. The patient's history included well-compensated secondary epilepsy. The root cause of the situation was a fever which had developed as a side effect of the vaccination.
A 56-year-old man received the first dose of mRNA-1273 vaccine against the severe acute respiratory syndrome-coronavirus-2. The vaccine was administered intramuscularly (100 mg, 0.5 mL). The next morning the man was found to be suffering from fever and headaches while at the same time experiencing general weakness. He lost consciousness suddenly and experienced generalized clonic seizures which turned into status epilepticus. When the Emergency Medical Service arrived the patient was unconscious with spontaneous breathing and generalized clonic seizures. It was necessary to administer diazepam repeatedly. It was also necessary to administer high doses of levetiracetam and temporary propofol. The status epilepticus was brought under control approximately 90 min after the patient's transport to the Emergency Department. A follow-up electroencephalogram no longer revealed abnormal indications of epileptic fit. The patient was temporarily hospitalized in the Intensive Care Unit and after seven days care was discharged without any further apparent effects.
There is currently no specific treatment against COVID-19. Therefore, the benefits of COVID-19 vaccine protection outweigh the risks.
我们报告了一例56岁男性的癫痫持续状态罕见病例,该病例是在接种2019冠状病毒病(COVID-19)mRNA-1273疫苗后出现的并发症。患者有代偿良好的继发性癫痫病史。引发该情况的根本原因是接种疫苗产生的副作用——发热。
一名56岁男性接种了第一剂针对严重急性呼吸综合征冠状病毒2的mRNA-1273疫苗。疫苗通过肌肉注射(100毫克,0.5毫升)给药。第二天早上,该男子出现发热和头痛,同时伴有全身乏力。他突然失去意识,出现全身性阵挛性癫痫发作,并演变为癫痫持续状态。紧急医疗服务人员赶到时,患者昏迷,有自主呼吸,全身性阵挛性癫痫发作。需要反复注射地西泮。还需要给予高剂量的左乙拉西坦和临时使用丙泊酚。在患者被送往急诊科约90分钟后,癫痫持续状态得到控制。后续脑电图检查未再显示癫痫发作的异常迹象。患者在重症监护病房短暂住院,经过七天护理后出院,没有出现任何进一步的明显影响。
目前尚无针对COVID-19的特效治疗方法。因此,COVID-19疫苗保护的益处大于风险。